Ketogenic Diet
Very-low-carbohydrate, high-fat eating pattern that shifts the body into ketosis, using ketones from fat as a primary fuel.
A classical ketogenic diet typically provides ~70–80% of calories from fat, ~15–20% from protein, and only ~5–10% (often 20–50 g/day) from carbohydrates. The metabolic shift to ketosis lowers blood glucose and insulin, raises ketone bodies (beta-hydroxybutyrate, acetoacetate), and is being studied for neurological and metabolic conditions. Variants include the Modified Atkins Diet (MAD), Medium-Chain Triglyceride (MCT) ketogenic diet, and the Low Glycemic Index Treatment (LGIT).
Foods to emphasize
- Fatty fish (salmon, sardines, mackerel)
- Pasture-raised eggs
- Avocado and olives
- Extra-virgin olive oil, coconut oil, MCT oil
- Grass-fed meat and poultry
- Full-fat dairy (butter, ghee, hard cheeses)
- Nuts and seeds (macadamia, pecan, walnut, chia, flax)
- Low-carb leafy greens and cruciferous vegetables
- Bone broth and electrolyte-rich foods
Foods to avoid
- Sugar and sweetened beverages
- Grains and starches (bread, pasta, rice, cereal)
- Most fruit (except small portions of berries)
- Legumes and beans
- Starchy vegetables (potatoes, corn, peas)
- Low-fat or sweetened dairy
- Vegetable seed oils (soybean, corn, sunflower) in excess
- Most processed and packaged foods
Key principles
- Carbohydrate intake usually 20–50 g net carbs per day
- Adequate protein (~1.2–1.7 g/kg) — not high-protein
- Most calories from whole-food fats
- Track electrolytes (sodium, potassium, magnesium) to prevent "keto flu"
- Best initiated with clinician guidance if on medications for diabetes, blood pressure, or seizures
Typical duration: Often 3–6 months minimum to assess response; medically supervised protocols (e.g. for epilepsy) may be maintained for years.
Why it may help
Prediabetes: Rapid improvements in fasting glucose and HbA1c, often reversing prediabetes within months.
Type 2 Diabetes: Significant HbA1c and fasting glucose reductions in clinical trials. Monitor diabetes medications closely to avoid hypoglycemia.
Insulin Resistance: Most direct mechanism — lowers insulin demand by minimizing carbohydrate load.
Ketogenic therapy is a medical intervention when used for seizure disorders or oncology — work with a clinician or registered dietitian experienced in ketogenic therapy. Not recommended in pregnancy, type 1 diabetes without supervision, pancreatitis, certain fatty-acid oxidation disorders, or active eating disorders.